Terms used in this chapter mean:

1. (1) "Private health insurance," medical or hospital insurance coverage with benefits payable to or in behalf of an eligible recipient;
2. (2) "Probable existence of third-party liability," an indication in the individual's case record which suggests that a possible third-party resource exists which may be liable for the individual's medical expenses, or the identification of a third-party resource with a reasonable expectation that the third-party resource will pay on the claim; and
3. (3) "Third-party liability" or "third-party payment source," the obligation of an entity other than the medical assistance program for either partial or full payment of the medical cost of injury, disease, or disability. Third-party liability sources include coverage such as Medicare, private health insurance, worker's compensation, disability insurance, and automobile insurance.

Source: 7 SDR 23, effective September 18, 1980; 7 SDR 66, 7 SDR 89, effective July 1, 1981; 16 SDR 226, effective June 24, 1990; 26 SDR 168, effective July 1, 2000.

General Authority: SDCL 28-6-1.

Law Implemented: SDCL 28-6-1.